CPT 0584T: Pancreatic Islet Cell Transplantation, Intraportal Infusion - OpenPayer

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Summary & Overview

CPT 0584T: Pancreatic Islet Cell Transplantation, Intraportal Infusion

CPT code 0584T denotes pancreatic beta islet cell transplantation by infusion into the portal vein, performed to stimulate endogenous insulin production in patients with diabetes. This advanced interventional transplant procedure combines surgical access and image-guided radiologic infusion, with imaging and radiology services bundled into the code. Nationally, the code matters because it captures a specialized therapy with implications for transplant program coverage, payer policy development, and access to emerging biologic treatments.

Key payers referenced in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find an overview of clinical context for islet cell infusion procedures, typical sites of service, and the scope of services captured by the code. The publication summarizes payer coverage patterns and policy considerations, reimbursement benchmarks where available, coding and billing guidance related to bundled imaging and supervision, and relevant clinical indications that drive utilization. It also highlights areas where data are limited or variable and where policy clarification is commonly sought.

The content is intended for hospital billing managers, transplant program administrators, clinicians involved in islet cell therapy, and payer policy analysts seeking a concise national view of how CPT code 0584T is used and reimbursed across major payers.

AetnaBlue Cross Blue ShieldCigna HealthUnitedHealthcareMedicare0584TCPTislet cell transplantationpancreatic transplantationinterventional radiologytransplant surgerybundled imagingdiabetes therapy

Billing Code Overview

CPT code 0584T describes a pancreatic islet cell transplantation procedure in which pancreatic beta islet cells, sourced from the patient or a donor, are transplanted to stimulate insulin production in a patient with diabetes. The provider infuses the islet cells into the portal vein of the liver through a catheter inserted via a small abdominal skin incision. All imaging, imaging guidance, and radiological supervision and interpretation are included with this procedure.

Service type: Surgical/interventional transplant procedure involving intra-portal infusion of pancreatic islet cells
Typical site of service: Hospital operating room or interventional radiology suite with inpatient or outpatient admission depending on clinical need

Clinical & Coding Specifications

Clinical Context

A 45-year-old patient with type 1 diabetes refractory to optimized medical therapy and recurrent severe hypoglycemia undergoes autologous or allogeneic pancreatic beta islet cell transplantation. The multidisciplinary workflow begins with pre-procedure assessment by endocrinology and transplant surgery or interventional radiology: medical optimization, infectious disease screening, donor screening if allogeneic, and informed consent. On the day of the procedure the patient is brought to an interventional radiology or hybrid operating suite. Under conscious sedation or general anesthesia, the operator obtains image guidance (usually ultrasound and fluoroscopy) to access the portal venous system via a percutaneous transhepatic or transabdominal approach through a small abdominal skin incision. The islet cell preparation is infused slowly into the portal vein through a catheter or introducer; portal pressures are monitored. Radiological supervision and interpretation, intraoperative imaging, and any necessary fluoroscopic guidance are provided as part of the service. Post-procedure monitoring includes observation for bleeding, portal vein thrombosis, and graft function in an inpatient or ambulatory infusion recovery area. Typical sites of service are an interventional radiology suite, hybrid operating room, or hospital inpatient surgical unit depending on anesthesia and monitoring needs.

Coding Specifications

Modifier	Description	When to Use
`22`	Increased procedural services	Use when work required is substantially greater than typical for and documentation supports increased complexity.

0584T

Taxonomy Code	Specialty	Notes
208100000X	Interventional Radiology	Primary specialty performing percutaneous portal vein access and image-guided infusion.
208000000X	Diagnostic Radiology	Provides imaging guidance and radiological supervision/interpretation when involved.
207P00000X	Transplant Surgery	Surgical oversight for islet preparation, donor procurement coordination, and operative management.
207L00000X	General Surgery	May participate in access, hybrid operating room procedures, or multidisciplinary care.
163W00000X	Endocrinology	Manages pre- and post-transplant metabolic assessment and immunosuppression coordination.

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`E10.9`	Type 1 diabetes mellitus without complications	Common indication for islet cell transplantation when C-peptide negative and insulin dependence present.
`E11.9`	Type 2 diabetes mellitus without complications	Selected patients with severe insulin deficiency or metabolic indications may be considered for islet transplantation.
`E10.21`	Type 1 diabetes mellitus with diabetic nephropathy	Diabetes with end-organ complications can be part of the assessment for suitability and timing of transplantation.
`E10.65`	Type 1 diabetes mellitus with hyperglycemia	Indicates poorly controlled diabetes prompting consideration of advanced therapies.
`E10.641`	Type 1 diabetes mellitus with hypoglycemia with coma	Recurrent severe hypoglycemia is a common clinical driver for considering islet transplantation.
`T86.820`	Organ transplant rejection	Relevant for post-transplant monitoring and coding if rejection occurs after islet transplantation.
`Z48.22`	Encounter for aftercare following kidney transplant	Example of post-transplant aftercare coding patterns; used when coordinating multisystem transplant aftercare.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`0584T`	Transplantation of pancreatic beta islet cells, implantation into the portal vein, including imaging guidance and radiological supervision and interpretation	Primary procedure for islet cell infusion into the portal vein to restore insulin production.
`76937`	Ultrasound guidance for vascular access requiring ultrasound evaluation and continuous ultrasound visualization	Often used for real-time ultrasound-guided percutaneous portal vein or hepatic access prior to infusion.
`36901`	Selective catheter placement, arterial, initial single vessel, up to 3 radiologic supervision and interpretation	May be reported when selective catheterization is required for vascular mapping or adjunct procedures (use per payer rules).
`36415`	Collection of venous blood by venipuncture	Routine pre-procedure blood draws for labs and serologies associated with transplant preparation.
`96365`	Intravenous infusion, therapeutic, prophylactic, or diagnostic; initial, up to 1 hour	May be used for concurrent infusion therapies or sedation medications when billed separately per payer guidance.